Analysis of clinical characteristics of thyroid disorders in patients with chronic hepatitis B treated with pegylated-interferon alpha

BMC Endocr Disord. 2023 May 22;23(1):115. doi: 10.1186/s12902-023-01371-w.

Abstract

Background: Thyroid disorders (TD) is a common complication of pegylated-interferon alpha (Peg-IFNα) therapy. Few studies have investigated the relationship between TD and the efficacy of interferon therapy for chronic hepatitis B (CHB). Therefore, we analyzed the clinical characteristics of TD in patients with CHB treated with Peg-IFNα, and evaluated the correlation between TD and Peg-IFNα treatment efficacy.

Methods: In this retrospective study, the clinical data of 146 patients with CHB receiving Peg-IFNα therapy were collected and analyzed.

Results: During the course of Peg-IFNα therapy, positive conversion of thyroid autoantibodies and TD occurred in 7.3% (85/1158) and 8.8% (105/1187) patients, respectively, and was diagnosed more often in women. The most common thyroid disorder was hyperthyroidism (53.3%), followed by subclinical hypothyroidism (34.3%). We found that thyroid function returned to normal in 78.7% of patients with CHB, and thyroid antibody levels returned to the negative range in approximately 50% of patients after interferon treatment cessation. Only 25% of patients with clinical TD required treatment. Compared with patients with hypothyroidism/subclinical hypothyroidism, patients with hyperthyroidism/subclinical hyperthyroidism showed greater reduction and seroclearance of hepatitis B surface antigen (HBsAg) levels.

Conclusions: TD are not an absolute contraindication for interferon therapy; however, patients should be monitored closely during interferon therapy. In pursuit of functional cure, a balance between efficacy and safety must be achieved.

Keywords: Chronic hepatitis B; Functional cure; Interferon alpha; Side effect; Thyroid diseases.

MeSH terms

  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use
  • Female
  • Hepatitis B Surface Antigens / therapeutic use
  • Hepatitis B, Chronic* / drug therapy
  • Humans
  • Hyperthyroidism* / chemically induced
  • Hyperthyroidism* / drug therapy
  • Hypothyroidism* / drug therapy
  • Interferon-alpha / adverse effects
  • Polyethylene Glycols / adverse effects
  • Recombinant Proteins / adverse effects
  • Retrospective Studies
  • Thyroid Diseases* / chemically induced
  • Thyroid Diseases* / epidemiology
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Hepatitis B Surface Antigens
  • Polyethylene Glycols
  • Recombinant Proteins